Microfilariae of Wuchereria bancrofti in cyst fluid of tumors of the brain: A report of three cases

Abstract

Microfilariae of various nematodes, including Loa loa, Dirofilariae, and Onchocerca volvulus, have been identified in the central nervous system (CNS). The CNS, however, is a rare site for the isolation of microfilariae of Wuchereria bancrofti. To the best of our knowledge, the presence of microfilariae of W. bancrofti in tumor cyst fluids or cerebrospinal fluid has not been reported to date. We report three cases in which microfilariae were identified in the cyst fluid of tumors of the brain. Cyst fluid aspirated from space-occupying lesions in the thalamus and C6-D1 spinal segments in a 46-yr-old man and a 35-yr-old man, respectively, showed numerous microfilariae of W. bancrofti, along with fragments of tumor suggestive of glioma. In the third case, in a 12-yr-old boy, the fluid from the space-occupying lesion in the third ventricle showed microfilariae in a necrotic dirty background with a few squames and cholesteral crystals. Histopathologic examination of the tumor showed an anaplastic astrocytoma and a low-grade astrocytoma in the first two cases, respectively, and a craniopharyngioma in the third case. No microfilariae were identified on the histology sections.

Role of Fine Needle Aspiration Cytology in Detection of Microfilariae

“…11,15 This finding is consistent with the observation that filariasis can exist without microfilaremia, while asymptomatic microfilaremia may also be found, especially in those living in endemic areas. 11 A proportion of individuals in endemic areas show neither microfilariae in the blood nor any symptoms.…”

Morphological Variations in Microfilaria of <b><i>Wuchereria bancrofti</i></b> in Cytology Smears: A Morphometric Study of 32 Cases

“…A number of reports on microfilaria of W. bancrofti found by aspiration and exfoliative cytology have been published [5,6,7,8,9,10,11,12,13,14]. A few reports of B. malayi found by aspiration cytology are also available [15].…”

Neurologic manifestations of the neglected tropical diseases

“…It is unclear whether the CNS symptoms in these cases were a result of high fever and systemic complications of parasitemia or true CNS involvement. Filaria have rarely been isolated from the CSF in cases of meningoencephalitis (Mansonella species) [82,83], from the brain at autopsy [80], and in cyst fluid surrounding intracranial neoplasms [84]. A single case of paraplegia from a Pott's-like syndrome caused by pathologically confirmed microfilariasis of vertebral and paravertebral tissue was reported to have resolved completely with diethylcarbamazine citrate (DEC) [85].…”